This week’s Economist has a fine summary of how refugees have grown in number and diversity, and the international community’s response to these changes. Among things to note is the continuing trend observed a few years ago in a JAMA commentary (and critiqued by a skeptic or two… oops) of urban resettlement, which UNHCR now says it prefers to people resettling in refugee camps. UNHCR is also more explicit about its policy encouraging local political integration and even economic development as solutions in long-term refugee crises. These efforts are mirrored by changes in policies of countries who receive the most refugees (overwhelmingly in the developing world).

David Apollo Kazungu, Uganda’s Commissioner for Refugees, says it no longer makes sense to treat refugees as a humanitarian issue. “Those who stay for years throw up developmental problems for us, such as how to find enough land, water and jobs for everyone,” he argues. Uganda has already tried to improve the lot for the nearly 200,000 refugees it hosts by placing them in settlements rather than camps, and by giving them land to farm.

Within this discussion is the acknowledgement that forced migration and voluntary (or economic) migration are not entirely separate phenomena. Read the entire article here.

The Northwestern University Conference on Human Rights (NUCHR) is in its 8th year, and this year’s topic is Human Rights in Transit: Issues of Forced Migration. NUCHR is probably the best student-organized conference on human rights issues, addressing a given topic over a three days of lectures, study sections, and speeches. NUCHR involves college students from around the US through a lengthy application process which attracts hundreds. Successful applicants become NUCHR “Delegates,” with assigned working groups and specific areas in which they become experts. After a day and half here, I can tell you that this is really one top-notch group of thinkers and doers, at any level of the academic hierarchy.

Today’s panels were “Defining Forced Migration” and “The Displaced: The Psychological and Cultural Effects of Forced Migration” (which is why yours truly is here — I was a panelist in the latter). Defining Forced Migration featured legal scholars Deborah Anker of Harvard Law School Immigration and Refugee Clinical Program, Howard Adelman from the Griffith University in Brisbane (Australia), Susan Gzesh of the Human Rights Program at University of Chicago, and Maureen Lynch of Refugees International in Washington, DC. It’s always instructive for refugee service providers (and people who think a lot about providing refugees services, like me) to hear legal perspectives on our field. Anker made the point that refugee law is first and foremost “palliative, not political” — meaning that it is primarily designed to relieve tension instead of solve the difficult situations that cause displacement — and so it’s place in the “human rights regime” (which is political) is tenuous. I have often thought that refugee healthcare — also primarily palliative — is in a similar bind; while healing may have political consequences in that it may make people able to more easily demand that their rights be respected, it is not the case that healing is in and of itself a political act (not usually anyways). When people ask me about “health and human rights” I usually tell them that what I do is health, rarely human rights.

Howard Adelman gave a comprehensive history of refugee policy, and said something I had been completely ignorant of: the first refugee policies in international law were Wilsonian (as in Woodrow Wilson) efforts to bolster the idea of nation states by transferring minority ethnic groups out of one state to others. In other words, their goal was to make homogenous states and these “ethnically pure” states would somehow be less likely to have internal conflicts. It wasn’t until after World War II (during which ethnic purity had some rather nasty consequences) that refugee law began to shift to protection of individuals who would be persecuted if they returned to their home countries. This was primarily designed with Cold War refugees in mind. Adelman also pointed out that the “right of return” — a value at the intersection of human rights and refugee rights — has never been successfully implemented by anything other than force (e.g., Tutsis in Rwanda); most peacefully negotiated returns have involved only a few, mostly older refugee returnees and many who came home, sold their stuff, and went back to their (richer) host countries (e.g., Bosnian refugees). Adelman’s history lesson leaves us with some sobering contemplation about where we go from here — although exactly what we should do differently isn’t quite clear.

The United States Supreme Court is hearing a torture case today, but not one involving Guantanamo, Abu Ghraib, or Bagram. NPR’s Morning Edition reported this morning on the case of Bashe Yousuf, a Somali refugee living in the US suing a former leader of Somalia, Mohammed Ali Samanatar, who is also a Somali refugee living in the US.

The lead plaintiff is Bashe Yousuf, a Somali businessman who was doing volunteer work to clean up hospitals in 1983 when he and fellow volunteers were arrested. He was tortured for several months — subjected to electric shocks, trussed up and hung for hours, and waterboarded. And then he was held in solitary confinement for six years. In 1989, he was finally released and granted asylum in the United States, where he is now a citizen.

The case in front of the Justices pits the Torture Victim Protection Act against the Foreign Sovereign Immunities Act. The conflict, back and forth in Federal courts in Virginia, is essentially over foreign dignitaries can be sued in the US for torturing their own citizens. Although both plaintiff and defendant are both now in the US, at the time of the torture they were not, and so this case wades into the rather sticky legal territory of applying US law to things that happened in other countries.

Although this is clearly not an “enhanced interrogation” case, Mr. Yousuf’s case strikes a particular chord these days, in ways that cases previous to the revelations at Abu Ghraib (e.g., the case of an Ethiopian refugee suing her past torturer a few years ago) did not.

He is suing Samantar, he says, not because he fears for his safety anymore, but to make the man answer for his crimes.

“It’s outraging me,” he says, “that somebody like him can live in America.”

2009 will be remembered in Cambodia as the year of the first Khmer Rouge Tribunal. Duch (born Kang Kek Lew), head of the torture center S-21 during the Khmer Rouge was put on trial, causing considerable consternation for some, and some small measure of consolation for many who lived through that era (1975-79). This soul-searching, however, seems to have had little effect on the Cambodian government, as was recently shown by Cambodia’s expulsion of Uighur asylum seekers in exchange for foreign investment from China. (More background here.) Twenty Uighurs had sought asylum in Cambodia following China’s crackdown following the unrest in western China this past July. For those of you who don’t know, the Uighurs are a Turkic Muslim minority in China, and have in the past few years resisted aspects of Beijing’s development strategy of the Xinjiang Uighur Autnomous Region (which, of course, is not really autonomous), involving encouraging Han Chinese from the East to “go west.” Incidently, Xiinjiang’s Governor, the architect of the repression of protests this summer, had a similar job before this one: head of the Tibetan Autonomous Region.

Why did the Uighurs go to Cambodia? If you look on a map of Asia, it’d be hard from them to go farther and remain on the mainland. Well, Cambodia is one of only a very few countries in the region to have signed UN Convention Relating to the Status of Refugees. The others in East Asia are Japan, South Korea, the Philippines, and… China. (Central Asia has a few signatories, though I might think twice before applying for asylum in Kazakhstan; South Asia, surprisingly to me, has none.) During the Khmer Rouge millions fled Cambodia to neighboring states as refugees (neighboring states that were not particularly welcoming), and many sought asylum around the world. So it makes sense that if any country in the Asia were going to be sensitive to the needs of refugees and asylum seekers it would be Cambodia. And there are, therefore, asylum seekers from around the world who have successfully sought asylum in Cambodia.

But China is the biggest investor in Cambodia, and therefore has a voice in Cambodian affairs. The Chinese are calling the twenty Uighurs criminals (of course, in a country that doesn’t allow protest, protestors are criminals), so Cambodia calls them “illegal aliens,” and expels them. Two days after the expulsion, Cambodia signed a deal with China for $850 million.

December 16, 2009 — This afternoon the Associated Press is reporting that Immigration and Customs Enforcement (ICE) will release asylum seekers who enter the US once they establish that they have a credible fear of returning to their home countries (here reported by the Las Vegas Sun — I bet you Las Vegans didn’t think I read the Sun, did you). If this is as likely as it looks, it means that years of the rather inhumane practice of locking up people who have already been persecuted while they wait for their immigration hearing is about to end. This practice included putting a many potential asylees quite literally in jail –many areas of the country are without nearby detention facilities and use local jails — for moths and even years at a time. Those not in jails went to immigration detention centers. Problems with immigration detention facilities abound, including inadequate space, housing criminal and non-criminal immigrants together, and in several centers, substantial abuse by staff members. For more on asylee detention conditions, see prison condition expert Craig Haney’s summary in the US Commission on International Religious Freedom’s report on Expedited Removal, the Clinton-era policy that started it all. (Full disclosure: I wrote part of another section of the report, so maybe I’m biased; also, I think Craig Haney’s a pretty good guy, so I am biased. As an aside, Craig Haney’s dissertation was the Stanford Prison Experiments.)

So, what does it mean to say that potential asylum seekers won’t be detained any longer? Well, it doesn’t mean that they won’t be detained. In other words, it doesn’t meant that they will say “I want asylum,” be given an appointment slip for a hearing, and then simply be let go from the airport. We used to do that, prior to 1996. Not surprisingly, not many people showed up for their hearings (for those of you who think this was not a problem, keep in mind that Ramzi Yusef, the guy who bombed the World Trade Center the first time around – 1993 – was one of those folks who never showed up). What this does mean, if I read the reports correctly, is that potential asylees who claim asylum at an airport will be detained for as long as it takes for them to have a Credible Fear Interview.

What is a Credible Fear Interview, and perhaps more importantly, when does it happen? A Credible Fear Interview is an interview in which an official who is more specialized in asylum law and knows more about dangerous countries than the Customs and Border Patrol officers talks to potential asylees and figures out whether or not they have a legitimate fear of returning to their country (i.e., would they be harmed by authorities). Credible Fear Interviews are supposed to happen within a week or so — but really happen within a few weeks. So asylum seekers will remain detained for some period of time.

If Credible Fear is established, what happens then? I presume that potential asylees will be released and told to see an Asylum Officer a few weeks later who will judge the merits of their asylum claim (different from a Credible Fear Interview in that the bar is set higher). If Credible Fear is not established, the no-longer-potential asylee will get sent home on the next plane back (at their airline’s expense, in case you were wondering).

All this is not to say that the change announced today is not huge. Since 1996, potential asylees would be detained weeks following the Credible Fear Interview until their Asylum Interview, and then, when that was not resolved (Asylum Interviews more often than not end in a referral to Immigration Court), months or years until their Immigration Court hearing was resolved. This caused those who fled from persecution substantial suffering. Today’s change will save future asylees months, if not years, of what is essentially jail time for crimes they not only did not commit, but indeed, have had inflicted upon them.

A few years ago I published an article on injuries and PTSD among Punjabi Sikh torture survivors in Abnormal Psychology with my colleagues Barry Rosenfeld (Fordham University), Kim Reeves (Simon Fraser University), and my boss, Allen Keller. The manuscript grew out of a forensic assessment done at the request of a couple Indian human rights NGO’s (who I will refrain from naming without their permission) invovled in a large, class action lawsuit alleging torture and abuse inflicted by the Indian government in the 1980s and early 1990s. My colleagues and I were connected to the lawsuit via Physicians for Human Rights. Jas Sandhu, an addiction counselor in Surrey, British Columbia found my article in Abnormal Psychology and invited me out to speak at an annual conference he organizes surrounding Sikh culture, at Kwantlen Polytechnic University. Surrey, just outside of Vancouver, is home to Canada’s oldest Sikh communities, and one of its largest.

What? You’ve never heard of any campaign of abuse targeting Sikhs in India? A brief history: Following the partition of British India into India for Hindus and Pakistan for Muslims, some among the nation’s third largest religious group, the Sikhs, felt that their interests were left out. A move for more autonomy (“Khalistan”) developed for the only Sikh majority state in India, Punjab, and a small minority started to openly carry guns. In 1984, this militant faction housed itself in the Golden Temple in Amritsar, the “Vatican of Sikhdom,” and the Indian Army attacked the temple. Reprisals came a few months later, when Indian Prime Minister Indira Ghandi’s Sikh bodyguards assassinated her. This was followed by what is known as the Delhi Massacre, in which mobs of Hindus sought out Sikhs in the capital and slaughtered them. Dark days followed. The Federal Government shut down the Punjab state government, the militancy grew, and a scorched earth counter-insurgency campaign was put into full effect, carried out mostly by Punjab state police. Young Sikh men, particularly those who were religious or even looked religious (turbans, uncut beards, steel bracelets, among other distinctions), were swept up indiscriminately. The estimates of those “disappeared” during this time ranges between 25,000 and 75,000 (the broad estimate gives you a sense of just how little is known about exactly what was going on). The militancy was harsh as well, accusing many of collaboration with the authorities, and, as in many such conflicts, many people who had never been political were caught in the crossfire. Punjabi police routinely used torture and threats to get information about the militants, and the militants regularly used torture and threats to intimidate the population. Eventually the militancy was effectively stamped out. Few participants in violence on either side were charged and prosecuted through the courts.

This morning I spoke about how my colleagues and I went about using research methods to document events and assess damages due the litigants. The audience was a group of about 100 or so, some Kwantlen students, some professional counselors, some members of the local Sikh community. The question and answer session (my favorite part of any talk) was a mixed bag about the experience of being an evaluator, psychiatric diagnoses, and evidence-based treatment recommendations for these diagnoses. The last question, from Jas Sandhu, concerned collective identity. Last year a few 15-year old teenage Sikh boys in Surrey had found a website with t-shirts promoting Khalistan with crossed AK-47s on them. They wore them to school, and were quickly suspended for promoting antisocial behavior. Jas has seen my CV, so he knows I worked as a disciplinary dean in New York Public Schools, and he asked me how I would have dealt with these kids. I asked him what the problem was. He explained the situation again, and my response was the same, and then I went on to explain that I don’t think we do anyone any favors by silencing youthful exploration of identity even when we think the tone of that exploration is misguided. Young people need to discuss these things, they need to know their families’ histories, their communities’ histories, in order to make decisions about how to live their lives. It’s only when we don’t discuss these things that they choose simplistic, sometime violent interpretations: Black and Latino gangs, White Supremacist organizations, etc. So assign homework on history of the Khalistan movement, on the consequences of using an AK-47, on the insurgency and counterinsurgency — don’t just call them dangerous or stupid.

What really shook me about Jas’ example was not, however, how these teenagers used their collective identity or the liberal school system’s response, but how the horrific era of the 1980s and early 1990s, so far removed in time and space from present-day western Canada, would resonate so strongly there even today. It was a perfect example of how even far-off, localized conflicts from a previous generation effect our lives in the present day. The complex stories of conflicts that seem long ago and far away are hardly irrelevant; they are real, alive, even vibrant in the present day.

The following was sent to me by my friend and transcultural psychology colleague Ambreen Mirza. Ambreen is a counselor and supervisor working at TPO Cambodia, in Phnom Penh (see posts from 6/13 and 6/17 of this blog for more on TPO Cambodia), and she’s been going regularly to the ongoing trial of Duch. The following description of Cambodian Psychiatrist Chimm Soetheara’s testimony is lengthy for the blogosphere (even for this blog), but worth every word. Thanks much to her for the donation of her time and her report.

A Great Day for Mental Health

Yesterday I spent the morning at the Extraordinary Chambers of the Courts of Cambodia for the Khmer Rouge Tribunal. Psychiatrist Dr. Chimm Sotheara, the Director of TPO, the organization I work with, testified as an expert witness at the trial against the accused, Kaing Guek Eav or “Duch”. I have been to the tribunal many times before, but this testimony was different from all the others. Dr. Sotheara is the first Cambodian expert witness to testify at the tribunal, though he himself was only seven years old when the regime came into power.

Tears, deep sighs, long pauses, raised voices, and lowered eyes of various witnesses thus far have all hinted at the psychological impact Pol Pot’s Khmer Rouge regime had on Cambodians, yet Dr. Sotheara, one of Cambodia’s few qualified psychiatrists, is the first expert witness to provide a public testimony of the wide-spread and on-going effect of that trauma.

He talked about two strains of impact. First he focused on the psychological impact on the individual: how the trauma of imprisonment, torture, starvation, slave labor, witnessing deaths, and being forced to execute loved ones has left survivors with severe anxiety and post traumatic stress. Symptoms consist of recurring nightmares, avoidance of people and places that bring back painful memories, and hypersensitivity to everyday events which may trigger flashbacks. He shared how many of his patients and other survivors are alcoholics, physically and verbally abusive, victims of domestic violence and/ or are suffering from depression.

He then outlined how the Khmer Rouge systematically broke down the very fabric of Cambodian society: children were separated from their parents, and instead “belonged” to Angkar (The Organization). Those lucky enough to live with their parents were forced to spy on them for the regime. Husbands and wives were separated, extended family members lost and killed. In essence, the regime severed relationships, destroyed the sense of community, safety, and spirituality. After the regime ended in 1979, Cambodians had lost the structures that would have allowed them to heal from trauma. There was no family, no teachers, no doctors, no monks, no honoring of the dead, no comfort, no closure, and no justice. The very institutions that would help Cambodia recover from the immense trauma no longer existed.

Thirty years later, survivors are still suffering. According to a research conducted by Jeffrey Sonis, over 14% of Cambodians over the age of 18 show symptoms of post-traumatic stress. Dr. Sotheara is one of 32 psychiatrists in the country, and one of the first 10 trained by psychiatrists from Oslo University in 1994. He had no intention of becoming one, but as a medical doctor working with UNTAC in 1992, trauma and suffering were so prevalent that it became an obvious choice

During the course of the testimony one of the co-prosecutors commented that many of the civil parties dropped out due to fear of facing Duch. Another civil party lawyer shared that his clients felt that the deaths at S-21 lacked motive, they were senseless killings, deaths for nothing. He wondered if this in turn could create more confusion for their clients, and increase their trauma. Another asked Dr. Sotheara’s opinion about guilt and the widely used defense that members of the Khmer Rouge were strictly following orders; kill or be killed. He first stated that if the perpetrator was an adult at the time, and not a child, they should be responsible for their actions. However the concept of guilt was far more complex in this scenario. Often times there weren’t clear cut perpetrators and victims. He was referring to members of the Khmer Rouge who were themselves later detained, tortured and killed (such as in prison S-24) by the very regime they served. Perpetrators became victims and victims became perpetrators. Many of the civil parties that recently testified against Duch are ex-Khmer Rouge, mainly prison guards, interrogators, and medics. This trial is different from others, such as that in Rwanda, where there was a clear ethnic divide between perpetrators and victims.

He did stress, however, the importance of tribunals such as this one, where their past and experiences are no longer abstract, crimes are being acknowledged, their pain and suffering validated, where they are given a voice, and they can seek and obtain justice (albeit three decades later). The majority of survivors have been living side by side with perpetrators for decades; they have had no choice but to learn how to co-exist. But despite this, a survey conducted by the UC Berkeley Human Rights Center shows that four out of five respondents said they harbored feelings of animosity towards those Khmer Rouge members who were responsible for violent acts. Seventy-one percent said they wanted to see them suffer in some way. A third said they wished they could take revenge (37%) against former Khmer Rouge and that they would do so if they had the opportunity (40%). (So We Will Never Forget: A Population-based Survey on Attitudes about Social Reconstruction and the Extraordinary Chambers in the Courts of Cambodia, January 2009.)

One of the co-defense lawyers commented that Duch was not responsible for all of the suffering of the survivors of the Khmer Rouge regime, and was being tried for his role in the S-21 prison. He highlighted the resilience of the Cambodian people, that the country is slowly rising up, making its mark, and is flourishing in many ways. He added that after this tribunal, he imagines Cambodians will be able to “turn the page”. Dr. Sotheara agreed that the tribunal is extremely important, and that for some it would provide answers, healing and closure. For others, however, it could be a trigger for them to re-experience the atrocities committed, and revive the memories of what they suffered.

The co-defense lawyer also mentioned that Duch had sought forgiveness from the Cambodian people, and asked what it would take for them to forgive. Dr. Sotheara answered that telling the truth was very important, as was accepting ones actions and admitting guilt. However forgiveness is a process, one that will not happen overnight. There is forgiveness at the individual level, some will never let go of the anger, and some may feel relieved by the truth that emerges from this tribunal. Buddhists may forgive but know that the perpetrator will get their due karma in their next life. In the humanistic sense, people will forgive when justice is served.

He also stressed that forgiveness needs to happen at the community level, and stressed the need for the creation of local reconciliation commissions alongside the Khmer Rouge Tribunal. This, he said, should be a joint effort of the NGOs, local authorities, and the government, to establish reconciliation forums as an avenue to heal the pain of the victims.

Duch listened intently as Dr. Sotheara testified. As per usual at the end of a testimony, he was given a chance to comment or respond to the witness (via the President). He said he was fascinated with what Dr. Sotheara had testified, as he himself has no psychological knowledge (umm, forced confessions, torture…??). He said crimes against humanity were committed and the consequences still continue, and that he accepts responsibility for all crimes at S-21, “legally and psychologically”. He expressed his “gratitude” and congratulated Dr. Sotheara for his “outstanding achievements” and bowed before he was led out.

Dr. Sotheara’s testimony lasted three and a half hours, extending beyond the usual time, during which the mood at the court was distinctly different from other days. There was a sense of calm and relief amongst the witnesses, other survivors, the prosecutors, and even the defense; almost as if the elephant in the room had finally been acknowledged. The President of the Chamber (who has been previously criticized for asking witnesses to “compose themselves” and to “remember they were doing this for Cambodia”) was quiet for the most part, but nodded in agreement many times while leaning back in his chair and processing. Civil parties shared with TPO counselors later that they felt Dr. Sotheara’s testimony was what they had been waiting for and they felt truly understood. Most of all, the feelings of thousands of people who were not present were validated and their past experiences and present pain were given a voice.

Duch’s trial will be over by the end of September, but hopefully this testimony will pave the way for more sensitivity in the cases to follow, and greater recognition and action regarding current mental health issues and needs in Cambodia.